Nursing is licensed one state at a time. Every state and the District of Columbia runs its own board of nursing, writes its own rules about what a nurse practitioner may do without a physician, and pays its own rates. This section holds an article on each of them, covering the board and how to reach it, compact membership, practice authority, nursing education and the shape of the local job market.
Four things vary enough between states to be worth understanding before reading any single article.
Licensure. In a Nurse Licensure Compact state a nurse holds one multistate license and may practice in every other compact state without applying again. Forty jurisdictions have implemented it. Eleven of the fifty-one covered here have not: Alaska, California, the District of Columbia, Hawaii, Illinois, Massachusetts, Michigan, Minnesota, Nevada, New York and Oregon. Massachusetts has passed compact legislation but has never put it into effect. Working in any of those eleven means applying for a license by endorsement.
Practice authority. Twenty-seven states and the District of Columbia let nurse practitioners evaluate, order tests and prescribe under the nursing board's own authority. Twelve require a standing collaborative agreement with a physician for at least one part of the job, and eleven require supervision or delegation. See nurse practitioner practice authority.
Staffing law. Four states mandate nurse to patient ratios. California covers every hospital unit, Oregon covers hospital units under a 2023 law, Massachusetts covers intensive care and burn units, and New York covers intensive and critical care. A larger group, including Texas and Washington, requires staffing committees and written plans instead of fixed numbers. See nurse staffing and patient outcomes.
Geography. Most inpatient care outside metropolitan areas happens in critical access hospitals, and forty-five states have them. What the work is like there is covered under rural and frontier nursing.
States
Regions follow the Census Bureau's four groupings, which is also how the site's own state data is organized.
Where the numbers come from
Every article gives the state's population and the annual mean wage for registered nurses, with the wage ranked against the other fifty jurisdictions. Population is the Census Bureau's estimate for July 1, 2025. Pay is the Bureau of Labor Statistics wage survey for May 2025, occupation code 29-1141, and the ranks are calculated from those same figures. The national picture is under registered nurse pay.
Board addresses and telephone numbers were checked against each board's own published contact page. Compact membership and implementation dates come from the compact's own status data. Practice authority follows the American Association of Nurse Practitioners classification.
Related pages
- Nurse Licensure Compact
- Licensure by endorsement
- Nurse practitioner practice authority
- Nurse practice acts and boards of nursing
- Registered nurse pay
- Critical access hospitals
- Rural and frontier nursing
- Scope of practice
Sources
- U.S. Census Bureau, state population estimates for July 1, 2025. Accessed September 8, 2026.
- U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics, registered nurses (29-1141), May 2025. Accessed September 8, 2026.
- Nurse Licensure Compact, member states and implementation status. Accessed September 8, 2026.
- American Association of Nurse Practitioners, State Practice Environment. Accessed September 8, 2026.
- Critical Access Hospital locations list. Flex Monitoring Team. Accessed September 8, 2026.